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  1. Goleg FA, Kong NC, Sahathevan R
    Int Urol Nephrol, 2014 Aug;46(8):1581-7.
    PMID: 24671275 DOI: 10.1007/s11255-014-0694-1
    PURPOSE: End-stage kidney disease (ESKD) is now a worldwide pandemic. In concert with this, ESKD in Libya has also increased exponentially in recent decades. This review aims to define the magnitude of and risks for this ESKD epidemic among Libyans as there is a dearth of published data on this subject.

    METHODS: A systematic review was conducted by searching PubMed, EMBASE and Google scholar databases to identify all relevant papers published in English from 2003 to 2012, using the following keywords: end stage, terminal, chronic, renal, kidney, risk factors, Arab, North Africa and Libya.

    RESULTS: In 2003, the reported incidence of ESKD and prevalence of dialysis-treated ESKD in Libya were the same at 200 per million population (pmp). In 2007, the prevalence of dialysis-treated ESKD was 350 pmp, but the true incidence of ESKD was not available. The most recent published WHO data in 2012 showed the incidence of dialysis-treated ESKD had risen to 282 pmp and the prevalence of dialysis-treated ESKD had reached 624 pmp. The leading causes of ESKD were diabetic kidney disease (26.5 %), chronic glomerulonephritis (21.1 %), hypertensive nephropathy (14.6 %) and congenital/hereditary disease (12.3 %). The total number of dialysis centers was 40 with 61 nephrologists. Nephrologist/internist to patient ratio was 1:40, and nurse to patient ratio was 1:3.7. Only 135 living-related kidney transplants had been performed between 2004 and 2007. There were no published data on most macroeconomic and renal service factors.

    CONCLUSIONS: ESKD is a major public health problem in Libya with diabetic kidney disease and chronic glomerulonephritis being the leading causes. The most frequent co-morbidities were hypertension, obesity and the metabolic syndrome. In addition to provision of RRT, preventive strategies are also urgently needed for a holistic integrated renal care system.

  2. Cader RA, Ibrahim OA, Paul S, Gafor HA, Mohd R
    Int Urol Nephrol, 2014 Jun;46(6):1209-15.
    PMID: 24307428 DOI: 10.1007/s11255-013-0615-8
    PURPOSE: Cardiovascular disease is the leading cause of mortality in dialysis patients with left ventricular hypertrophy (LVH) being an important predictor of mortality. We wanted to determine the prevalence of LVH in peritoneal dialysis (PD) patients and factors contributing to it.

    METHODS: This is a cross-sectional study assessing LVH using echocardiogram in PD patients. Left ventricular mass index (LVMI) was calculated to determine LVH. Chronic fluid overload (overhydration) was assessed using the body composition monitor, and blood pressure (BP) was measured using 24-h ambulatory BP monitoring.

    RESULTS: Thirty-one patients (21 females:10 males, 48.97 ± 14.50 years and dialysis vintage 40.0 ± 28.9 months) were studied. More than two-thirds (77.4 %) were hypertensive, and a third (35.5 %) were diabetic. Baseline data included mean serum albumin (37.34 ± 4.43 g/l), weekly Kt/V (2.02 ± 0.23), residual renal function of 68 (0-880) ml and ultrafiltration of 1,606.9 ± 548.6 ml. Majority of patients (80.6 %) had LVH on echocardiogram with LVMI of 136.5 ± 37.8 g/m(2) and overhydration of 2.23 ± 1.77 l. Average systolic BP, diastolic BP and mean arterial pressure were 141.2 ± 23.3, 90.8 ± 19.7 and 107.6 ± 19.6 mmHg, respectively. Patients with LVH had a lower serum albumin (p = 0.003), were more overhydrated (p = 0.010) and were on higher number of anti-hypertensive agents (p ≤ 0.001). Predictors of LVMI were overhydration (p = 0.002), the presence of diabetes (p = 0.008) and the number of anti-hypertensive agents used (p = 0.026). However, overhydration (p = 0.007) was the main predictor of LVH on multivariate analysis.

    CONCLUSION: Overhydration is strongly associated with LVH in PD patients.

  3. Inn FX, Ahmed N, Hou LG, Abidin ZAZ, Yi LL, Zainuddin ZM
    Int Urol Nephrol, 2019 Nov;51(11):1949-1953.
    PMID: 31441009 DOI: 10.1007/s11255-019-02262-7
    PURPOSE: The internal drainage provided by a ureteral stent helps with the relief and prevention of ureteral obstruction. By definition, correct stent placement is one with a complete loop in both the renal pelvis and bladder. This prevents stent migration proximally or distally despite urinary flow, patient movement, and ureteral peristalsis.

    METHODS: We performed a comparative prospective cross-sectional study assessing the impact of intravesical stent position on the quality of life in 46 patients with a ureteral stent. This is done using the Ureteral Stent Symptom Questionnaire (USSQ).

    RESULTS: 52.5% of patients had an ipsilateral positioned intravesical stent, while the remaining had their stent positioned contralaterally. Intravesical stent position significantly influenced the quality of life. The USSQ score was worse for the contralateral group. Subscore analysis found that urinary symptoms and body pain index contribute significantly to the morbidity. Majority of patients in the ipsilateral group reported no discomfort as compared to the contralateral group.

    CONCLUSIONS: To the best of our knowledge, this is the first study assessing the impact of intravesical stent position on the quality of life in the Asian population. Intravesical stent position has a significant influence on patient's morbidity and quality of life in particular towards their urinary irritative symptoms and body pain. It is imperative to ensure correct distal placement of ureteric stent that does not cross the midline to the contralateral site. We believe that the USSQ should be used in daily clinical practice in assessing the symptoms related to indwelling ureteric stents.

  4. Ch'ng LS, Toh CC, Sathiyananthan JR, Malek R
    Int Urol Nephrol, 2022 Mar;54(3):509-515.
    PMID: 35080681 DOI: 10.1007/s11255-022-03105-8
    PURPOSE: Stent encrustation is not uncommonly encountered with a high number of ureteric stents. The exact pathophysiology is not well understood. Therefore, we investigated the relationship between the use of sodium citrate and likelihood of stent encrustation.

    METHODS: This prospective, randomised, intervention study was conducted between October 2018 and October 2019 in a tertiary hospital. Overall, 115 patients with ureteral stents that were inserted after lithotripsy surgeries were recruited. The study subjects were randomised into two groups: one group was administered sodium citrate (Utix sachets) three times per day until stent removal (intervention group), and the second group was not administered Utix sachets (control group). Stents were removed after 1 month and inspected under macroscopic visualisation from the proximal to distal end for any crystallisation; a second inspection was done with a 60 × magnification lens. Any crystallisation observed was considered to be encrustation.

    RESULTS: Patients who had Utix sachets post-insertion of a ureteric stent constituted 50.4% of the study cohort. The rate of encrustation in the control group was 52.6%. In the intervention group, the rate of encrustation was 46.6%. The difference was not statistically significant with the chi-squared test (p value, 0.514).

    CONCLUSION: Alkaline citrate medications had no significant effect on stent encrustation rate. More studies are needed to elucidate different agents and their roles in reducing stent encrustation as it incurs high morbidity.

  5. Khan I, Khan AH, Adnan AS, Sulaiman SAS, Hamzah ABA, Ahmed N, et al.
    Int Urol Nephrol, 2018 Jun;50(6):1113-1121.
    PMID: 29536424 DOI: 10.1007/s11255-018-1834-9
    PURPOSE: Creatinine is normally used to evaluate kidney function among elderly patients in clinical practice, which has been reported to be affected by socio-demographic factors like BMI and age. Cystatin C a newly introduced biomarker may be more efficient in identifying kidney function in obese and aged CKD patients. The aim of the current study was to assess the effect of BMI on endogenous biomarkers (cystatin C and creatinine) among elderly CKD patients in Malaysia, a first such study in the country.

    METHODS: The current study was conducted at the Hospital University Sains Malaysia, Kelantan. A total of 300 elderly Malay participants ≥ 65 years, with CKD, were taken in study. Demographic data, blood pressure, weight, and height were documented. Serum creatinine was assayed by Chemistry Analyzer Model Architect-C8000 (Jaffe Method), while serum cystatin C was examined by Human cystatin C ELISA kit (Sigma-Aldrich) using Thermo Scientific Varioskan Flash ELISA reader.

    RESULTS: The study participants were divided into three groups on the basis of age. There was a statistically significant difference at the p value 

  6. AlSahow A, AlQallaf A, AlYousef A, Bahbahani H, Bahbahani Y, AlHelal B, et al.
    Int Urol Nephrol, 2023 Mar;55(3):721-727.
    PMID: 36136260 DOI: 10.1007/s11255-022-03368-1
    INTRODUCTION: Hemodialysis (HD) patients are at increased risk of severe COVID-19 infection but infection rates vary. Our objectives are to describe COVID-19 positive HD patients' characteristics, infection rates, and factors associated with mortality in HD COVID-19 cases in Kuwait.

    METHODS: Data on demographics, comorbidities, and treatments received, as well as mortality for HD patients admitted to hospitals for COVID-19, from 1/March to 31/July 2020, prospectively collected and analyzed.

    RESULTS: A total of 141 infected HD patients were admitted (Mean age 58 ± 16.1; Males 56%), representing 7% of the total HD population and 0.2% of all COVID-19 cases during the study period. Of those 141 infected HD patients, 27 (19%) died, and this represents 6% of total COVID-19-related mortality and 27% of the total HD mortality. In contrast, total covid-19-related mortality of all positive cases was only 0.7%, and total HD mortality during the study period was only 5%. COVID-19-positive HD patients who died were older and 59% were males. However, the differences were not statistically significant. Of the 61 infected HD patients who needed to be switched to continuous kidney replacement therapy (CKRT), 34% died, and of the 29 infected HD patients who needed admission to intensive care, 65% died.

    CONCLUSION: HD population represents a small fraction of the total population; however, positive HD COVID-19 cases represent a sizable proportion of COVID-19 cases and a significant percentage of total COVID-19-related mortality, and total HD mortality.

  7. Daneshwar D, Nordin A
    Int Urol Nephrol, 2023 Dec;55(12):3133-3145.
    PMID: 37145375 DOI: 10.1007/s11255-023-03616-y
    BACKGROUND: Prostatitis is known as the inflammation of the prostate. The treatments of prostatitis are either pharmacological or non-pharmacological treatment. However, some of the treatments are not effective and very invasive which can lead to side effects. Thus, low-intensity extracorporeal shockwave therapy (LI-ESWT) is used as an alternative treatment for prostatitis due to its convenient and non-invasive procedure. However, a definite protocol for this treatment is not available due to the variability of the treatment protocols and the lack of research comparing the efficacy of these protocols.

    OBJECTIVE: To review and compare the efficacy of different LI-ESWT protocols in treating prostatitis.

    METHODS: The study was performed by comparing the intensity, duration, frequency and combination with different types of pharmacotherapy drugs of the different LI-ESWT protocols from various studies. The finding from various studies which consist of disease improvement and quality of life (QoL) were also presented in this review.

    RESULT: From the findings, the protocol can be categorized into three different intensities which are at 3000 pulses,  3000 pulses. Most studies reported that each protocol is very effective and safe to use and can improve CP symptoms, urinary symptoms, erectile function and QoL. It is also found that no complications or adverse effects occur to the patient.

    CONCLUSION: Most of the LI-ESWT protocols described are safe and effective in treating CP through the absence of treatment-related adverse effects and maintenance of clinical effects.

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